Grand Rounds 3.07

It's a week for celebration! It is National Medical Staff Services Awareness Week, and the second anniversary of the MSSPNexus Blog. What better way to celebrate than by hosting edition 3.07 of Grand Rounds. Welcome!

Some of you may remember that last year about this time Leonard McCoy, M.D., "Bones" from the original 1960's Star Trek was accidentally beamed into my office. So this year I figured I'd better keep my wits about me and my eyes open for any fluctuation in the time-space continuum...

Deciding that the rumblings in my stomach required attention, I headed for the hospital cafeteria, dreaming of something green and leafy of course.

On the way I noticed a man who appeared to be a bit dazed. A stethoscope dangled haphazardly from the pocket of his lab coat. "May I help point you in the right direction?" I asked cheerfully as I approached.

"I'm not sure" he replied as he turned toward me with a bemused smile and a hint of New England in his tone. "I can't quite figure out where I am."

Instantly my Credentialer Senses went on high alert. (Similar to Spidey Senses, but in this case they sniff out doctors who may not be 'as advertised'.) In all my years working in medical staff administration, never have I personally uncovered a total fraud, one of those Dennis Roark types who just decides one day that being called doctor might be kind of cool. But something about this "doc" seems a bit off, and I begin to wonder who this slightly confused soul standing before me might prove to be.

"Where is it you want to go?" I asked, noting that the photo ID badge he is wearing is not standard issue.

"The Emergency Department" he responded with a touch of arrogance, "I have a patient waiting."

I grew even more suspicious in view of his inability to locate his own patients, and began to wonder whether I might have just met my first physician impostor.

"Okay, who are you, and what are you doing wandering the hallways of the Cleveland Clinic?" I asked.

"Cleveland? That's quite impossible! I can't be in Cleveland, I am Charles Emerson Winchester, III, Chief of Thoracic Surgery at Boston Mercy Hospital!

Uh-oh, it's that time-space continuum thing again. Something about combining Medical Staff Services Week and Grand Rounds seems to cause a disruption in the classic television force field. Dr. McCoy would sympathize.

"Sorry Dr. Winchester, Cleveland it is; but take heart, since you're an aficionado of classical music, you'll love our orchestra."

"Yes well, be that as it may I have patients to attend to and no time to dawdle, will you assist me in locating them?"

Smiling reassuringly, I extended my hand. "I'll need to see your license, DEA, and proof of malpractice insurance please. I'll contact my colleagues at Boston Mercy, run a check for OIG exclusions, and query the National Practitioner Data Bank. Take a walk with me; we'll stop by my office and pick up a few forms."

"What!? he asked in his best 'I save lives every day and who are you to question my credentials' voice. "I believe that my word should be quite good enough! I graduated summa cum laude from Harvard Medical School I'll have you know!"

"Oh I'm sure everything will check out fine. In the meantime, I just happen to be hosting Grand Rounds this week. I believe that our friends in the medical blogging community will be able to both entertain and educate us while we wait."

"By the way, it's Medical Staff Services Awareness Week, did you happen to bring me a present...?"

"Well," he said patting his lab coat pockets "I do believe that I have an extra Godiva bar if that would suffice."

"Chocolate? That'll do. Hand it over!" (Note to all potential medical staff applicants, chocolate is a good gift...)

"Thanks for the treat Dr. Winchester, and now I have one for you, this week's collection of the best of the medical blogosphere - Grand Rounds."   

From Is there A Doctor in the House, the touching story of It.

From Surgeon's Blog, the story of Big Joe: living proof of our fallibility; of useful tests that can mislead; of procedures aimed toward helping that sometimes make things worse.

Six Until Me ponders her well-stocked medicine cabinet, and wonders what would happen to it if she ever really got sick.

From Emergiblog: Consider yourself a little crazy? Perhaps nursing is the career choice for you.

Aggravated DocSurg reveals how a date with IRIS may help you avoid the need for a central line.

Aidan Charles (The Examining Room of Dr. Charles) has just announced publication of his second book! Trinities is a collection of tales, essays, and poems drawn from his favorite blog posts.  Congratulations to one of the medical blogosphere's most gifted writers.

The Tangled Neuron's Antipsychotic Medications and Alzheimer's chronicles one phase of a daughter's search for answers about her father's dementia.

Straight From the Doc tells of research with engineered heparins, which may prevent the formation of the protein clumps that form in the brain and contribute to Alzheimer's.

True Confessions from Hsien-Hsien Lei of A Hearty Life.  She reveals that KFC is one of her favorite fast food indulgences, trans fats and all.   

The Diet Dish reminds us that large portions don’t always equate to boat loads of calories and small portions don’t always mean minimal calories in Portion Distortion.

Fixin' Healthcare offers tips on how to avoid gaining weight over the holidays.

Anxiety, Addiction & Depression Treatments wants to go on record in support of the Winterhaven, Florida Chief of Police who took a stand on obesity.

Good childhood nutrition can help ward off coronary atherosclerosis and heart disease later in life according to Disease Proof.

Nutrition & Life offers some common-sense tips on healthy living.

The Family Fork suggests that salt intake is linked to obesity, particularly in children.

Medpundit argues that shortening waiting room times for all emergency room visitors regardless of the nature of their illness, does not necessarily improve healthcare and reduce errors.

Rickety Contrivances of Doing Good spends a busy night in the ED and questions whether the "lunar effect" of the full moon is real.

Clinical Cases shares how custom Google search engines help patients find reliable medical information.

Movin' Meat explains why the decision not to settle a baseless malpractice claim is a lot like letting a bear maul you while hoping that he won't get all your food.

The Daily Rhino says that the summer after medical school finals is a glorious time - all the perks of being a doctor (i.e. telling people you are a doctor, and are thus superior to them) but none of the responsibilities. But after a few beers one Saturday night, it became quite another story.

Just Up the Dose reveals what she learned about the silkworm's scarf during her recent Urology rotation.

Anatomy Notes provides a lesson on referred pain. Sometimes the brain gets confused, making you think that one part of the body hurts, when in fact another part of the body, far removed from the pain, is the real source of trouble.

Medical student Anthony Rudine is concerned that some patients pay the price for physician training.

Medical student Kristen Heinan finds it hard to let go of what happens at the hospital when she's out in the "real world".

The Medical Blog Network has released HealthTrain, an Open Healthcare Manifesto.  Part of HealthTrain's goal is to work toward a new "integrity standard" for healthcare open media, including blogs. As of 10/20/06 there were 32 signed supporters, including several bloggers represented in this edition of Grand Rounds.

Neonatal doc wonders why some women don't seem to mind sporting a moustache.

Summer Sethi reminds us that radiologists are in demand

Not My Second Opinion investigates porphyria, hypertrichosis, and lepromatous leprosy, with a nod to Halloween.

It's a Nursing Thing asks for suggestions on performing trach care without turning an already critically ill patient hypoxic.

Fruit of the Womb advocates a preconceptional visit to your Ob/Gyn since the best prenatal care begins before conception.

"Am I going to get well?" The Cheerful Oncologist does his best to answer. 

Wandering Visitor wonders why with the possibility of developing a disease like Melanoma so many people are still baking on the beaches and going to tanning salons to look "healthy?"

Cancer Treatment & Survivorship addresses whether patients should discuss complementary & alternative therapies with their health care providers.

Diabetes Mine offers sound advice on the use of DexCom and Continuing Glucose Monitoring (CGM) in the management of diabetes.

Hospital Impact posts a patient letter, a daughter's thanks for the string quartet that played for her dying father in the hospital's palliative care unit.

Dr. Anonymous joins the Walmart Free Antibiotics discussion and reminds docs to have the courage to 'just say no' to unnecessary antibiotic prescriptions, and patients to hold back their wrath if they don't get the prescription they were hoping for.

InsureBlog jumps into the Walmart discussion with kudos to the retailer for establishing a low-cost generic prescription plan.

Health Business Blog, reporting from the Harvard Business School alumni health care conference, thinks the Biogen CEO talks sense when he discusses regaining our perspective on risk.

Dr. Enoch Choi of Tech Medicine chronicles of the woes of trying to appropriately immunize children while complying with recently passed California law.

UK Community Pharmacist opens a new blog with a post about documenting patient interventions.

Dr. Deborah Serani looks at the world-wide epidemic of school violence.

Teen Health 411 warns of the dangers of excessive web use by teens, and adds that maybe it's time we encourage them to interact with people in the community and make some friends the old-fashioned way.

Barbados Butterfly reflects on recent referrals; who needs sleep anyway?

Inside Surgery advises Stay off the roof!  Falls are the second most common trauma fatality in the US in people aged 18 to 49 years of age.

Medicine for the Outdoors answers the question "should patients with head injury be kept awake?"

A Chronic Dose heads to the gym and confronts her own insecurities in the form of blond ambition. 

The Fitness Fixer gives lessons in good stretching technique (forget lunge and lean.)

   

Stay tuned for next week's episode of Grand Rounds, hosted at The Rumors Were True.  This week Topher compares learning a stack of stuff in medical school to eating a stack of pancakes every morning. I submit that hosting Grand Rounds is much the same - eat up!  : )

Comments

[TheTundraPA]

Rita--what a great job! And a few good chuckles to go with... Sorry I didn't get a post in this week (so big already, wow). Thanks for hosting.

[Kim]

This is perfect! Parts of it are perfect, other parts are also perfect and the intro is perfect. Entertaining, easy to follow, a reminder that I have to get off my blog-reading butt and keep up with my blogger colleagues and a perfect coffee-reading experience shall await me tomorrow morning!!!!

(PS Charles Emerson Winchester III was my favorite character after Hawkeye - hey, what can I say, Alan Alda was a hunk in the day!)

[Doctor Anonymous]

Great job with Grand Rounds! Thanks for hosting.

[riverwren]

Rita, nice work! I like the MASH angle, and the headings make for easy reading!

[hgstern]

 
Outstanding job, Rita! Great choices, easy to navigate, interesting layout.

Thank you so much for hosting!
 

[Kerri.]

Thank you very much for including my post as one of your editor's picks! Great edition of Grand Rounds ... it's my pleasure to be included. :)

[Dr. Deb]

Rita,
Love GR this week. The layout is easy to follow and fun to navigate!

~Deb

[enoch choi]

Great job! Nice short summary links.

[Carrie Locke]

This is one of the funniest Grand Rounds I've read. Maybe it's because I'm such a fan of M*A*S*H. Thank you so much for hosting. Great job!

[Cyndy King]

Thanks for this fantastic grand rounds. You made me laugh and we know that laughter can help heal

[Jennifer]

Thanks for the good laugh and a great intro! Chocolate is THE best thing for the Medical Staff Office!!

(My favorite M*A*S*Her was always Ferret Face)

[Sumer Sethi]

Great work!!

[Andrea N. Giancoli]

Fabulous and witty Grand Rounds! Many Thanx for being a fantastic host :)